8 ms·

May be we should have more supply, less regulation & more open information on pricing. (in the US you can't get a quote on your medical bill beforehand in many

May be we should have more supply, less regulation & more open information on pricing. (in the US you can't get a quote on your medical bill beforehand in many places) Currently the hospitals are working in an environment where the market forces can't work properly. That's why the prices of the medical services are so expensive. No competition, limited supply, over regulation, incentives between the hospitals and the insurers are bad. The argument of "it's too important to be for profit" is wrong, because food is "for profit" and it's not perfect, but the market forces the big retailers to work with 2-4% margin. Hospitals aren't like that. For profit hospitals work with 14% average operating profit margin (3-5 times higher) because of the regulated industry. This is a classical microeconomics problem of supply and demand. Markets are good at that to drive the price down. For people who can't afford it the government may redistribute the taxes from the healthy people to pay for treatment. The cheaper is the treatment, the better it will be for all.

nobody9999 1y ago
>This is a classical microeconomics problem of supply and demand. Markets are good at that to drive the price down. For people who can't afford it the government may redistribute the taxes from the healthy people to pay for treatment. While it is something of a trope, I'm not sure I want to be (or would be able to do so) doing price comparisons between hospitals (or ambulances for that matter) as my internal organs ooze onto the pavement after being struck by a semi truck and dragged 40 meters. That's the primary issue with using price signals in a healthcare setting. Especially in a system where the recipient of services doesn't actually pay the total costs out-of-pocket for those services. Which creates perverse incentives for both the payer and the provider. And since that's not likely to change anytime soon, a single-payer system makes a lot of sense. Non-emergency treatment/care not related to any emergency care would definitely benefit from increased supply and more information. What, specific regulations would you like to see removed from hospital settings? I want to emphasize that this is not a rhetorical question.
- freefaler 1y ago
  The supply of doctors and nurses (invite from abroad), certification of medical equipment & FDA drug approval (if it's certified in a normal country do a very lightweight approval process). If the patients want it, allow for more risk on his side. For drug prices, the current system is also very, very broken. Remove the PBMs from the drug supply and at least there allow for market forces to work. It's a classical problem of resource allocation that can't be avoided with just good intentions. Medical tourism in countries like Israel & Thailand shows that this can be allocated through market forces.
  - nobody9999 1y ago
    >The supply of doctors and nurses (invite from abroad), certification of medical equipment & FDA drug approval (if it's certified in a normal country do a very lightweight approval process). If the patients want it, allow for more risk on his side. >For drug prices, the current system is also very, very broken. Remove the PBMs from the drug supply and at least there allow for market forces to work. Sadly, the current government seems set on thwarting those suggestions. >It's a classical problem of resource allocation that can't be avoided with just good intentions. Medical tourism in countries like Israel & Thailand shows that this can be allocated through market forces. Where are you seeing anyone even paying lip service to some nebulous idea of "good intentions?" While I agree that market forces can be useful in certain situations (cf. Germany, Japan, and others), but basic health care, emergency services, life-saving care and a raft of other services aren't improved with to a race to the bottom.
  - ceejayoz 1y ago
    > FDA drug approval (if it's certified in a normal country do a very lightweight approval process) https://en.wikipedia.org/wiki/Frances_Oldham_Kelsey https://en.wikipedia.org/wiki/Frances_Oldham_Kelsey would like a word. (She saved the US from thalidomide's birth defects, despite European and Canadian approvals and a whole lot of industry pressure.)
rickydroll 1y ago
Let's say you're lying on the sidewalk and having a heart attack. What do you want to do? Get to the nearest hospital so you have a chance at surviving? Alternatively, conduct a market survey to determine which option offers the best prices for cardiac care. Market forces don't work for medical for many reasons. It begins with paying the shareholders dividends. That money should go to medical care. Same with C-suite compensation. Every time I hear of a medical system executive getting tens of millions of dollars in compensation, I think, "How many people could get medical care for that money?" $1 million in compensation is roughly equivalent to the annual healthcare premium for 65 people. Then you have specialized clinics, such as MRIs or ENTs, which also have to generate their profits and pay their shareholders and CEOs. I'm reminded of the time I had to see a gastroenterologist, and the place I was recommended was an extremely well-furnished, high-priced luxury office, with a 15-foot-wide, 8-foot-tall aquarium filled with cichlids. Why were they pissing money away on fancy furnishings and an expensive-to-buy and maintain aquarium instead of using the money to take care of patients? We have sufficient experience with financial engineering in other industries to know that applying financial rules to the medical environment is likely to result in worse patient outcomes and a higher concentration of wealth for a few.

nobody9999 1y ago

>This is a classical microeconomics problem of supply and demand. Markets are good at that to drive the price down. For people who can't afford it the government may redistribute the taxes from the healthy people to pay for treatment. While it is something of a trope, I'm not sure I want to be (or would be able to do so) doing price comparisons between hospitals (or ambulances for that matter) as my internal organs ooze onto the pavement after being struck by a semi truck and dragged 40 meters. That's the primary issue with using price signals in a healthcare setting. Especially in a system where the recipient of services doesn't actually pay the total costs out-of-pocket for those services. Which creates perverse incentives for both the payer and the provider. And since that's not likely to change anytime soon, a single-payer system makes a lot of sense. Non-emergency treatment/care not related to any emergency care would definitely benefit from increased supply and more information. What, specific regulations would you like to see removed from hospital settings? I want to emphasize that this is not a rhetorical question.

freefaler 1y ago
The supply of doctors and nurses (invite from abroad), certification of medical equipment & FDA drug approval (if it's certified in a normal country do a very lightweight approval process). If the patients want it, allow for more risk on his side. For drug prices, the current system is also very, very broken. Remove the PBMs from the drug supply and at least there allow for market forces to work. It's a classical problem of resource allocation that can't be avoided with just good intentions. Medical tourism in countries like Israel & Thailand shows that this can be allocated through market forces.
- nobody9999 1y ago
  >The supply of doctors and nurses (invite from abroad), certification of medical equipment & FDA drug approval (if it's certified in a normal country do a very lightweight approval process). If the patients want it, allow for more risk on his side. >For drug prices, the current system is also very, very broken. Remove the PBMs from the drug supply and at least there allow for market forces to work. Sadly, the current government seems set on thwarting those suggestions. >It's a classical problem of resource allocation that can't be avoided with just good intentions. Medical tourism in countries like Israel & Thailand shows that this can be allocated through market forces. Where are you seeing anyone even paying lip service to some nebulous idea of "good intentions?" While I agree that market forces can be useful in certain situations (cf. Germany, Japan, and others), but basic health care, emergency services, life-saving care and a raft of other services aren't improved with to a race to the bottom.
- ceejayoz 1y ago
  > FDA drug approval (if it's certified in a normal country do a very lightweight approval process) https://en.wikipedia.org/wiki/Frances_Oldham_Kelsey https://en.wikipedia.org/wiki/Frances_Oldham_Kelsey would like a word. (She saved the US from thalidomide's birth defects, despite European and Canadian approvals and a whole lot of industry pressure.)

rickydroll 1y ago

Let's say you're lying on the sidewalk and having a heart attack. What do you want to do? Get to the nearest hospital so you have a chance at surviving? Alternatively, conduct a market survey to determine which option offers the best prices for cardiac care. Market forces don't work for medical for many reasons. It begins with paying the shareholders dividends. That money should go to medical care. Same with C-suite compensation. Every time I hear of a medical system executive getting tens of millions of dollars in compensation, I think, "How many people could get medical care for that money?" $1 million in compensation is roughly equivalent to the annual healthcare premium for 65 people. Then you have specialized clinics, such as MRIs or ENTs, which also have to generate their profits and pay their shareholders and CEOs. I'm reminded of the time I had to see a gastroenterologist, and the place I was recommended was an extremely well-furnished, high-priced luxury office, with a 15-foot-wide, 8-foot-tall aquarium filled with cichlids. Why were they pissing money away on fancy furnishings and an expensive-to-buy and maintain aquarium instead of using the money to take care of patients? We have sufficient experience with financial engineering in other industries to know that applying financial rules to the medical environment is likely to result in worse patient outcomes and a higher concentration of wealth for a few.